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A drug shortage makes it harder to treat a surge in syphilis cases


There's been a surge nationwide in syphilis cases. The sexually transmitted infection can often be treated with a simple shot. But as Nashville Public Radio's Catherine Sweeney reports, a drug shortage makes it harder to treat syphilis.

CATHERINE SWEENEY, BYLINE: Walking into Nashville's main public health clinic, you see big, splashy posters about what they do best - vaccines for all ages and treatment for sexually transmitted diseases. But in the back, they're coping with a shortage.

LAURA VARNIER: Penicillin isn't here.

SWEENEY: Laura Varnier, the head nurse, shows me the huge metal refrigerator where they store penicillin shots. Usually, anyone who comes to this clinic with syphilis could get one and be on their way. It's the go-to treatment for the sexually transmitted infection. But now they're rationing the shots.

VARNIER: We pivoted in July, and we would say any of our patients that came in that were positive with syphilis were treated with doxycycline.

SWEENEY: That's an oral antibiotic. It is equally effective. But you have to take the pills for weeks. And they often have side effects, like nausea or diarrhea or increased sun sensitivity. But doxycycline can cause birth defects. So pregnant people with syphilis absolutely can't take it. That's why this health department and others across the country are saving the penicillin shots for pregnant patients so they don't pass that infection on to the baby. The shortage of penicillin shots started last spring. A few things led to this. First, a lot of people are getting syphilis. The Centers for Disease Control and Prevention says cases are the highest they've been in seven decades. Next, there is a shortage of a different antibiotic, amoxicillin, often used for strep throat. Pediatricians couldn't get that, so they turned to penicillin shots as a substitute. And those shots have a supply problem. There's only one manufacturer in the U.S., Pfizer. Erin Fox, a pharmacist and professor at the University of Utah, says only a giant like Pfizer can afford to make these shots. Most penicillin is made for IV drips. There's less demand for the shot form. And Fox says it must be made carefully.

ERIN FOX: You know, a lot of people are allergic to penicillin, and so it's that contamination factor. That means you can't make other drugs on that manufacturing line. It's not necessarily efficient or necessarily profitable for a very low cost drug.

SWEENEY: A Pfizer spokesman said the company is spending almost $40 million in the Michigan facility that makes these shots, including hiring more workers, and that the shortage should ease up by the summer. For NPR News, I'm Catherine Sweeney in Nashville.

MARTÍNEZ: This story comes from NPR's partnership with WPLN and KFF Health News. Transcript provided by NPR, Copyright NPR.

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Catherine Sweeney